Provider Demographics
NPI:1831306067
Name:BULA, THELMARIE
Entity Type:Individual
Prefix:
First Name:THELMARIE
Middle Name:
Last Name:BULA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COM EL PARAISO CALLE A #271
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-0304
Mailing Address - Country:US
Mailing Address - Phone:787-841-3396
Mailing Address - Fax:
Practice Address - Street 1:CARR 149 KM 58 1
Practice Address - Street 2:HECTOR PIERRA SANTA
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766
Practice Address - Country:US
Practice Address - Phone:787-841-3396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3024183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician